How to lower cholesterol
Do you need to know how to lower cholesterol? You are in the right place! This article purpose is to give you a comprehensive overview on how to reduce cholesterol with different methods.
In short, you can lower cholesterol in the following ways:
- Taking medications: the most prescribed are statins but there are alternatives like: Ezetimibe, Fibrates, Bile Acid Sequestrants, PCSK9 Inhibitors and ACL inhibitor.
- Integrating with supplements: niacin, omega-3 fatty acids, red yeast rice, fish oil, soluble fiber, garlic and L-carnitine.
- Following a healthy diet: eat more unsaturated fats, plant sterols or stanols, add whey protein to your diet and discontinue trans fats.
- Adopting a healthy lifestyle: exercise and move more, quit smoking, slow down in alcohol consumption and lose some weight.
What is cholesterol?
Before to talk about how to lower cholesterol, let’s see what cholesterol is. By definition, cholesterol is a fat-like, waxy substance that belongs to the lipid family. It is mainly produced by our body, liver especially (70%), but it is also introduced into the body by certain foods.
Cholesterol functions in the body
Cholesterol plays several vital roles in our body that include:
- Building blocks: cholesterol is part of every cell in the human body and it is responsible for maintaining the cell membranes fluidity and integrity.
- Steroid hormones production: cholesterol acts as a precursor for the synthesis of steroid hormones included sex hormones like progesterone, estradiol and estrogen in women as well as testosterone in men.
- Vitamin D production.
- Aids in the digestion process: another vital cholesterol function is to create bile. Made in the liver, it breaks down large chunks of fat into smaller pieces so they can be digested.
- Helps in the healing process: surgery procedures require the surgeon to cut tissues, small capillaries, veins and arteries. After the procedure, our body reacts immediately sending LDLs through the bloodstream to repair the affected tissue and vessels.
- Acts as antioxidant: cholesterol helps to get rid of free radicals coming from wounds.
LDL cholesterol vs HDL
There are two different types of cholesterol:
- LDL (Low-Density Lipoprotein): this type of cholesterol is also known as “bad cholesterol” because accumulates in the arteries narrowing them causing heart attack, stroke and peripheral artery disease (PAD).
- HDL (High-Density Lipoprotein cholesterol): this is also called “good cholesterol”. Its role is to navigate the bloodstream to catch excess bad cholesterol in the arteries. HDLs carry LDLs back to the liver for disposal.
While monitoring your blood pressure and cholesterol levels to decrease the risk of heart disease, there is another guy you should to put an eye on: your triglycerides.
Triglycerides are also a type of fat, the most common one, your body stores in the cells. When the body needs energy and it doesn’t come from food, it releases triglycerides.
High level of triglycerides is equal to high risk of heart problems such as coronary artery disease.
High level of cholesterol and triglycerides puts you at even higher health risks.
Total cholesterol indicates the total amount of cholesterol is in your blood. That amount includes both, LDL (low-density lipoprotein – the bad cholesterol) and HDL (high-density lipoprotein – the good cholesterol).
Total cholesterol = HDL + LDL + 20% triglycerides.
What is high cholesterol?
You have high cholesterol when there is extra fat-like, waxy substance in your blood vessels called arteries. Cholesterol tends to accumulate preventing the regular flow of blood to organs such as heart and brain.
Sometimes, cholesterol deposits can suddenly detach from the artery walls creating a clot that completely blocks the blood flow. The consequence may be heart attack, kidney failure or stroke (ictus).
Extra cholesterol production by the body explains why some people have high cholesterol despite they follow a low cholesterol diet. When the body produces more cholesterol than in normal people. The condition is called familial hypercholesterolemia.
How do I know if I have high cholesterol?
The only way to know exactly if you have high cholesterol and/or triglycerides is to undergo a blood test called lipid panel.
The test is done with a blood sample that a nurse takes from your arm using a syringe and needle.
When you undergo the blood sample for the lipid panel, be sure to let your doctor know about the following: the medicine, vitamins, herbs and supplements you are taking. Remember to include in the list even over-the-counter (OTC = medicines you do not need a prescription for) drugs.
In addition, be sure your healthcare provider knows about any illicit drugs you may use.
What are normal cholesterol levels?
In the United States, the lipid panel shows results in milligrams per deciliter (mg/dL). The blood test results may be affected by different factors such as: your age, the method used to do the lipid panel, your gender and health history.
The following are the lipid panel reference levels.
Total cholesterol levels in adults
|Less than 200 mg/dL
|200 to 239 mg/dL
|Equal to or above 240 mg/dL
LDL cholesterol levels in adults
|Less than 100 mg/dL
|100 to 129 mg/dL
|130 to 159 mg/dL
|160 to 189 mg/dL
|190 mg/dL and higher
HDL cholesterol levels in adults
|60 mg/dL or higher
|low41mg/dL to 59 mg/dL
|less than 40 mg/dL
Triglycerides levels in adults
|Less than 150 mg/dL
|150 to 199 mg/dL
|200 to 499 mg/dL
|Above 500 mg/dL
The above levels/readings are reported as general guidelines. In fact, your lipid panel results may also be affected by the heart disease risk factors you may have. Talk to your doctor what the blood test results actually mean in your specific case.
Depending on your lipid panel results, your doctor will decide whether you need a special diet, lifestyle changes or medicines to lower your cholesterol.
How to lower cholesterol by medications
Since most of the cholesterol in the blood is produced by the liver, chances are diet, supplements and exercises may not be enough to lower the excess of cholesterol in the bloodstream. If this is the case, your doctor may prescribe you cholesterol-lowering medications.
Statins are the first line of defense against high cholesterol and its severe complications. Statins are available on the market in different types since the 1980s. most common statins are: Simvastatin (Zocor), Atorvastatin (Lipitor) and Rosuvastatin (Crestor).
Statins mechanism of action
With some differences between each type of statin, this cholesterol-lowering drug works in two different ways.
The first is that they significantly or completely reduce the production of cholesterol by the liver.
Secondly, they promote the re-absorption of LDLs thus preventing the plaques formation on the arteries walls.
Statins are very effective cholesterol-lowering drugs and are commonly well tolerated by most people. However, they treat the symptoms and not the cause, therefore they work until you take them and their effect ends when you stop taking them.
Statistics reveal that statins can lower cholesterol by 2 to 3 mmol/L. That means 40% to 50% less risk of occlusive vascular events.
Stopping statins safely
If you are taking statins since a while and for whatever reasons you want or you have to stop them, there is one safe way only to do that: following your doctor instruction. Since this drugs cut the risk of cardiovascular issue by half, suddenly stopping taking them doubles the risk of serious problems with the heart (heart attack) or brain (stroke).
Common types of Statins include:
Atorvastatin (brand name: Lipitor)
Atorvastatin is a cholesterol-lowering medication that performs a triple action: it acts to lower the bad cholesterol or LDL, to increase the good cholesterol levels and to lower triglycerides that are another type of fat found in the blood.
Rosuvastatin (brand name: Crestor)
Rosuvastatin has two main scopes. First, it blocks the HMG-CoA reductase enzyme making the liver to produce less cholesterol quantity. Second, Rosuvastatin increases the liver’s ability to absorb and eliminate bad cholesterol captured in the blood by HDLs.
Simvastatin (brand name: Zocor)
Like Atorvastatin, Simvastatin is a cholesterol-lowering medication the helps to decrease the risk of heart attack, stroke and other heart-health issues especially in people with coronary heart disease and diabetes. Simvastatin can be also used in children over 10 years old.
Patients who used this drug to lower cholesterol experienced fewer mild symptoms. As reported by Food and Drug Administration (FDA), you should pay attention to drugs interactions. Mixing Simvastatin and grapefruit, for instance, may increase the percentage of that statin in the blood causing dangerous consequences for your health.
Statins side effects
For most high cholesterol people, statins are a great solution to keep blood fat in check and ward off much more serious or life-threatening health problems. Those people will take statins for decade without experience any symptoms.
Unfortunately, this is not the case for everyone. In fact, if on one hand statins lower cholesterol, on the other they may even cause severe additional problems.
Muscle pain is the most common complaint among people taking statins. The pain can range from mild to severe but it can even be so intense that you cannot do your daily activities. In this last case, your doctor can either reduce the dosage of the cholesterol-lowering medication or look for an alternative.
Additional common statins symptoms include:
- physical tiredness;
- sleep problems;
- digestion problems;
- low blood platelet count.
Alternative drugs to statins
(Brand names: Zetia, Roszet, Lypqozet, Ezetrol, Nexlizet).
Ezetimibe is a cholesterol absorption inhibitor prescribed to patients who cannot lower cholesterol by diet and physical exercise.
Ezetimibe mechanism of action.
Ezetimibe acts in the intestine limiting the absorption of cholesterol from digested food. It also decreases the amount of cholesterol sent to the liver.
Ezetimibe side effects.
Allergic reaction to ezetimibe is very rare and it is easy to spot it. In case you have swelling of throat, lips, tongue and/or face call the emergency or your doctor. They will act immediately.
Side effects to this cholesterol-lowering medication are more frequent in seniors than in young patients. Main ezetimibe side effects include: muscle tissue breakdown, kidney failure, legs or arms pain, joint pain, diarrhea and cold symptoms.
Clofibrate (Atromid-S); Fenofibrate (TriCor, Fibricor and Lofibra); Gemfibrozil (Lopid).
Fibrates mechanism of action.
Fibrates are prescribed to patients whose cholesterol level is very high and may lead to pancreatitis. Fibrates work by lowering triglyceride levels. High triglycerides combined to low HDL levels raise the risk of stroke as well as heart disease.
Fibrates side effects.
Along with its main effect which is lower cholesterol, usually fibrates do not cause severe side effects. The most reported symptoms include: stuffy or runny nose and sneezing. Less common symptoms are: fever, stomach or muscle pains, nausea and vomiting.
Bile Acid Sequestrants
Colestid (colestipol), Welchol (colesevelam), Prevalite (cholestyramine). The first two are available as resin powder or tablets. Instead, cholestyramine is available as resin powder only. They are also known as bile acid resins or BARs.
Among other cholesterol-lowering drugs, sequestrants are the oldest and not the most effective. In fact, bile acid resins are usually prescribed to patients with moderately high cholesterol.
Bile Acid Sequestrants mechanism of action.
BARs bind to bile acids in the stomach. The combination of bile acids and the medication is not absorbed in the blood but excreted from the body in the feces.
The liver then converts cholesterol to create bile acids to compensate for the reduction caused by sequestrants. In this way, it is possible to lower cholesterol (the bad one) by 15% to 30%.
Bile Acid Sequestrants side effects.
Among other side effects, BARs may increase your triglyceride levels if taken for a long period. So, if you already suffer from high triglycerides, bile acid sequestrants may not be the right medication to lower your cholesterol. In the long run, sequestrants may lower vitamins absorption causing deficiencies. One of the most dangerous is the vitamin K deficiency. When you do not have enough vitamin K you cannot stop bleeding because the body is not able to form a clot.
Alirocumab (Praluent), Inclisiran (Leqvio) and Evolocumab (Repatha). PCSK9 inhibitors, are a relatively new drugs to lower cholesterol. Food and Drug Administration approved them in 2015, Inclisiran, instead, is the newest and have been approved in 2021.
Unfortunately, these drugs used to reduce cholesterol are expensive. The supply for one year of therapy costs more than $14,000.
PCSK9 Inhibitors mechanism of action.
PCSK9 (Proprotein Convertase Subtilisin/Kexin type 9 serine protease) Inhibitors,
There are receptors in out liver cells that have one scope only, to eliminate the excess of cholesterol.
Unfortunately, there also are PCSK9 proteins that destroy those receptors. Here is where inhibitors come into account. In fact, inhibitors bind to PCSK9 proteins and prevent them to do their job. In this way there are more receptors that can eliminate LDLs in the blood and lower your cholesterol.
PCSK9 inhibitors can decrease LDLs up to 47% reducing heart attack risk by 27%.
PCSK9 Inhibitors side effects.
Recent statistics have shown PCSK9 inhibitors may cause mild symptoms one in ten patients.
PCSK9 inhibitors symptoms include: joint and back pain, cold, nausea and more rarely vomiting.
Generic name: bempedoic acid, brand name Nexletol.
ACL (Adenosine Triphosphate-Citrate Lyase) inhibitor is prescribed to reduce LDLs (bad cholesterol) in adult with coronary artery disease (commonly called clogged arteries) or a hereditary condition known as heterozygous familial hypercholesterolemia (HeFH).
ACL inhibitor mechanism of action.
ACL inhibitor take action in the liver by prevent a protein from producing LDL cholesterol.
How to lower cholesterol with supplements
If you started exercising and eating healthy to improve your health and it is not enough, chances are you want to try to lower cholesterol with supplements.
With your doctor’s approval, you can add different nutrients to your diet to reduce LDL and triglyceride levels.
In case of high cholesterol, supplements can work by their own or along with medications. Usually, doctors prescribe supplements to support the drugs action while lowering unpleasant symptoms you may experience.
There is a wide range of supplements to reduce cholesterol you can chose from: niacin, omega-3 fatty acids, red yeast rice, fish oil, soluble fiber, aged garlic extract, L-carnitine, green tea extract, etc.
Niacin (Vitamin B3), also called nicotinic acid, is an essential nutrient the human body uses to transform the food in energy. Our body is not able to produce niacin by its self so we have to get that nutrient from food or supplements.
Niacin is used by the body to keep the skin, the digestive and the nervous system healthy.
Also, niacin can affect the total cholesterol by lowering LDLs and triglycerides. At the same time, nicotinic acid can slightly increase the good cholesterol (HDLs).
Some trials reported niacin can also lower lipoprotein A level which is an atherosclerosis risk factor.
Niacin is available on the market either as an over-the-counter (OTC) dietary supplement or in prescription form.
Most prescribed daily intake is 16 milligrams for men and a little bit less for women, 14 milligrams. Some clinician uses niacin to lower cholesterol along with statins.
Unfortunately, niacin doesn’t come side effects free. At high doses, nicotinic acid may cause the following symptoms:
- Skin flushing.
- Hot flashes.
Nicotinic acid also seems to interact with high blood pressure drugs by increasing their effect.
Due to lack of adequate scientific evidence about niacin to lower cholesterol, we highly recommend you to talk to your doctor before to take any supplement as self-medication.
Omega-3 Fatty Acids
Usually, people with high cholesterol also have high level of triglycerides which are a type of fat where the body stores the energy it doesn’t use immediately.
Omega-3 may reduce cardiovascular risk by lowering the triglycerides level especially in combination with a not balanced total cholesterol (low HDL and high LDL).
You can get Omega-3 either by eating fatty fish such as sardines and salmon or as supplement in tablet form.
Omega-3 supplements come from fish liver or synthesized from algae (aquatic plant).
The common Omega-3 dose is: 1 to 2g a day. You should also pay attention to Omega-3 Fatty Acids interactions with other medicines. For example, you may have some bleeding problems if you take Omega-3 in high doses and anticoagulant drugs (or blood thinners: medicines that prevent blood clots) such as Coumadin and Warfarin.
Red yeast rice
Some red yeast rice oral supplements contain monacolin K, the same active ingredient you can find in a cholesterol-lowering drug called lovastatin (Altoprev).
High amount of monacolin K can decrease the total cholesterol levels in your blood by reducing both the level of LDL and that of triglycerides.
Red yeast rice is a natural supplement but it doesn’t mean is safe. Taken to lower cholesterol, this supplement may make you experience the same symptoms like lovastatin. We are talking about: muscle disorders, kidney failure and liver damage.
An additional down side of red yeast rice is that it can be difficult to know the quality and the exact quantity of monacolin K contained in the over-the-counter product sold in the supermarket or online.
Last but not least, red yeast rice and its monacolin K may trigger interactions especially with: alcohol, grapefruit, niacin, cyclosporine, Statins, Cytochrome and hepatotoxic drugs.
Pregnant or breastfeeding women have to talk to their doctor before to take red yeast rice supplement to reduce cholesterol because it may harm the baby.
Several people think fish oil can lower cholesterol but, is it truth? Actually, there are two different schools of thought related to this topic.
- The first is that 6 g/day of fish oil may increase HDL cholesterol (the good one), especially in women. In other words, fish oil may increase the amount of High-density lipoprotein that is able to catch the bad cholesterol in the bloodstream and bring it to the liver to be eliminated. Here is the complete study).
- According to a 2013 study published on The New England Journal of Medicine), fish oil supplements cannot decrease the risk of heart attack or stroke especially in people at high risk of heart disease. Also, while high doses of fish oil could decrease blood triglyceride levels, on the other hand it would increase LDL (the bad cholesterol) levels.
Clinicians agree that in order to reduce cholesterol it is much better to eat fatty fish like sardines and salmon which are rich in omega-3 fatty acids.
Soluble fiber mixed with water creates a gel-like compound that binds with cholesterol so it is not absorbed by the intestine but excreted from the body.
You can assume soluble fiber in two different forms: dietary supplements or from your diet.
Studies report that 5 to 15g of soluble fiber a day can lower cholesterol by 5% to 10%.
Food rich in soluble fiber include:
- Citrus fruits
- Black beans
- Brussels sprouts
- Sweet potatoes
- Kidney beans.
Supplements rich in soluble fiber include:
- Acacia fiber
- Nopal cactus
- Psyllium powder
If you prefer supplements of soluble fiber to lower your cholesterol, you should pay attention to the label on the products you chose. FDA, in fact, allows soluble fiber manufacturers to apply the wording “heart-healthy”.
Garlic and aged garlic extract (AGE)
It is a common opinion that garlic can reduce cholesterol levels. We don’t want to dispel a myth but a meta-analysis conclusion clearly reports the following: “The available evidence from randomized controlled trial does not demonstrate any beneficial effects of garlic on serum cholesterol”.
Different is the case of Aged Garlic Extract (AGE). Studies on humans and animals “… showed that aged garlic extract … supplementation was effective in lowering plasma concentration of total cholesterol by 7% and LDL cholesterol by 10% …”.
The aged garlic extract intake is 500 milligrams a day.
As always, we recommend you to let your doctor know about your intention to assume garlic to reduce cholesterol before to take it.
L-carnitine is an amino acid derivative produced in the body from lysine and methionine. You can also assume L-carnitine by eating certain food like meat and fish. The scope of this chemical is to bring fatty acids into your cells to be used as energy.
L-carnitine is useful for different body functions and could improve the statins effect reducing LDLs (bad cholesterol).
This supplement is a valid option especially for diabetes who have to reduce cholesterol because L-carnitine prevents blood sugar rising.
How to lower cholesterol with diet
Lower cholesterol with diet is the first line of defense against high levels of fats in the blood which are the main cause of artery-clogging atherosclerosis as well as cardiovascular severe issues (stroke and heart). Making little changes in choosing the food you eat every day you can lower the cholesterol and the dangerous fats floating in your arteries.
There are different foods you can chose to fight fats in your bloodstream.
Some of them, like soluble fiber, attach to the cholesterol during the digestion avoiding the waxy-like fat substance to get into the blood flow.
Some others, like unsaturated fats, act more directly at the liver level by decreasing the LDLs production in favor of ketone bodies.
Last but not least, sterols and stanols fortified food are able to stop the body from absorbing cholesterol.
How long does it take to lower cholesterol with diet?
Statistics show that it may take from three to six months to lower cholesterol just with diet without medication. The curious fact is that it takes longer for women than for men. To get a more precise time-span, you should talk to your doctor.
Replace saturated fats with unsaturated fats
If you wonder how to lower cholesterol with diet, replacing saturated fats with unsaturated fats is a good starting point.
Unsaturated fats, in fact, are well known to reduce the VLDL (very low-density lipoprotein) that carries more triglycerides as well as LDL (low-density lipoprotein) which contains more cholesterol.
When LDL and VLDL are very high in your blood, heart complication may occur.
Unsaturated fats contribute to reduce the risk of cardiovascular disease because the liver prefers to convert polyunsaturated fats into ketone bodies instead of into LDL triglycerides. The less triglycerides the better for your health.
Food rich in unsaturated fats
- Sesame seeds
- Canola oils
- Peanut oil
- Olive oil
Unsaturated fats are also available as supplement in tablets and capsules form.
How much unsaturated fat do I need daily?
Based on these Dietary Guidelines, women should get 1.5 to 2 tablespoons of unsaturated fat a day while men 2 to 2.5 tablespoons.
As general rule, you should keep the total fat consumption 25% to 30% of your daily calories intake.
Add plant sterols or stanols to your meals
Plant sterols or stanols have a cellular structure very similar to that of human cholesterol but, unlike the latter, they do not create plaques inside the arteries.
During digestion, our body absorbs plant sterols or stanols instead of cholesterol and the latter is eliminated by the liver. So, by adding plant sterols or stanols to your diet, you can improve the total cholesterol by lowering blood LDL cholesterol levels. This also reduces the risk of cardiovascular problems caused by clogged arteries.
What is the difference between plant sterols and stanols?
As mentioned by this meta-analysis, “… Plant sterols have a higher degree of absorption than plant stanols, suggesting differential efficacy between the two”.
Food rich in plant sterols or stanols
Sterols and/or stanols are available in natural food especially seeds and oils, as fortified food or as dietary supplements. Before to take plant sterols or stanols to lower cholesterol, talk to your doctor to know which quantity and form is best for you.
Natural food containing plant sterols or stanols:
- Sesame oil
- Pistachio nuts
- Sesame seeds
- Olive oil
- Cocoa butter oil
- Macadamia nuts
- Wheat germ oil
- Almond butter.
Plant sterols or stanols fortified food:
- Orange juice.
Add whey protein to your diet
Commonly, people who go to gyms use whey protein as a supplement to build lean body mass (muscle). So why should you use whey protein to reduce your cholesterol?
What is whey protein?
Casein and whey are the protein the milk is made from. With industrial process, it is possible to separate whey protein from casein.
Whey protein has unique features: it is low in lactose and contains all essential amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine).
Whey protein benefits
There are proven benefits associated with whey protein consumption:
- Promotes weight loss
- Has Anti-cancer properties
- Improve asthma
- Reduce blood pressure as well as the risk of developing heart disease or stroke
- Lowering cholesterol. Based on a study published in The British Journal of Nutrition, whey protein given to 70 overweight men and women for 12 weeks reduced their total cholesterol and LDL cholesterol in 12 weeks.
Whey protein side effects
Although whey protein is well tolerated, taken in high dosages it can cause some mild symptoms such as: nausea, bloating, tiredness, diarrhea and headache. Those side effects go away by their own as soon as you stop the consumption or you reduce its quantity.
Discontinue trans fats food
In case your doctor told you to try to lower cholesterol with diet, the first thing you should do is to eliminate trans fats food from your diet.
What are trans fats?
The food industry uses vegetable fats to produce margarine, biscuits, snacks, etc. The problem is that vegetable fats are liquid at room temperature so the products lose consistency.
To solve the problem, industries add hydrogen atoms in a process called hydrogenation. The resulting fats are called Partially Hydrogenated Oils (PHO) that are solid at room temperature and, therefore, more suitable for industrial food production.
Why are trans fats so bad?
Our body cannot process Partially Hydrogenated Oils as all other fats and this may cause mild to severe health issues such as:
- Increasing of Low-density Lipoprotein (LDL) the bad cholesterol
- Decreasing of High-density Lipoprotein (HDL) the good cholesterol
- Plaques accumulation in the arteries
- Insulin resistance
- type II diabetes mellitus
Food rich in trans fats
Here is a brief list of certain foods that may contain trans fats as necessary ingredient for the producing method used by manufactures.
- Commercial baked products (pies, cookies and cakes)
- Fillings and icings for cakes
- Frozen pizza
- Some sausages like wurstel
- Fried fast foods (french fries, fried chicken, milk-shake, chicken and shrimp croquettes)
- Microwave popcorn
- Nondairy coffee creamer
Trans fats do not come from industrial process only. In fact, you can find PHOs in natural food such as: dairy products and ruminant meat (cattle, sheep, goats and deer).
2-5% of milk fat and its derivatives is made from trans fats. 3-9% of beef and lamb fat is made from trans fats. PHOs form when bacteria in the ruminants stomach digest grass.
How to lower cholesterol by healthy lifestyle
Your lifestyle is the most important factor influencing your mental and physical health, including cholesterol, triglycerides and blood pressure.
Just by changing a few bad habits at a time, you can lose some extra pounds, improve resistance to fatigue, lower blood pressure, reduce blood cholesterol levels and more.
While a healthy lifestyle can have many benefits for your health, you should always remember that changing your habits won’t immediately lower your blood cholesterol, it takes time. Furthermore, it may not be enough to get the result that your doctor has indicated.
In some cases, you cannot skip cholesterol-lowering drugs (such as statins).
Below, you can read some tips about how to improve your health by changing your lifestyle.
You can also lower cholesterol with exercise. Physical activities that help to improve the total cholesterol quality and lower the LDL include: aerobic exercises (walking, swimming, running and cycling) and resistance training. At medium to high intensity, these physical exercises also contribute to raise the HDL cholesterol, the good one.
How much exercise should you do?
Based on this article titled “The Physical Activity Guidelines for Americans” you just need 150 minutes of moderate to intense physical activity (2,5 hours) a week to maintain or improve your overall health (blood pressure and cholesterol included).
The sad news is that only one in five American adults do enough physical exercise.
If you have high cholesterol, chances are you are overweight and a sedentary person.
Lower cholesterol with exercise may sound scary especially for those who haven’t exercised for a long time or have never done any.
The best way to reach the indicated two and a half hours of physical exercise is to do that step by step. Begin to exercise for 10–15 minutes two times a week for 1 month. Next, try increasing the time you spend on each workout and increasing your training frequency to 5 days a week.
Training intensity matters!
In order to maximize weight loss, cholesterol and blood pressure lowering, you should monitor the intensity of your workouts.
Based on the type of physical exercise, the WHO recommend:
- moderate intensity training: 150–300 minutes per week.
- vigorous intensity training: 75–150 minutes per week.
The exercise intensity is calculated based on your heart rate. When you are doing moderate physical activity, your heart rate is about 50% of maximum effort. In case of vigorous effort, the heart rate reaches 75% of its maximum.
Statistics reveal that exercising keeping the heart rate in between 50% and 75% of maximum effort helps to lower the bad cholesterol (LDL).
If you raise the rate of your heart to 85% you can also increase the good cholesterol (HDL).
Since we are not made all the same, here is a simple but effective way to calculate your maximum heart rate. Just subtract your age to 220 and you get your personal maximum heart rate. For example, if you are 40, just subtract 40 to 220. 180 is your maximum.
To track your heart rate there are different tools on the market. The more accurate is chest strap heart rate monitor followed by devices like smartwatches and wrist fitness tracker.
What kind of exercises you should do?
- Walking: 1 hour a day 5 days a week.
- Running: studies shown running may reduce by 27% the risk of death (not only heart attack or stroke).
Resistance training make your muscle strength to increase by using your body weigh as resistance or gym equipment like: dumbbells, weight machines or kettlebells.
Doing resistance training 3 times a week 40–50 minutes each session can reduce cholesterol (LDL) in your blood in about 14 weeks or so.
If you want to maximize the result and reduce your cholesterol quicker, you should alternate moderate and vigorous physical activity during the week.
How long does it take to lower cholesterol with exercise?
If you exercise regularly following the right training plan, you will see your LDL level reducing in 3 to 6 months. In order to increase the HDL level instead, you should train at least for 9 months or so.
We all know that cigarette smoking is very harmful to our health. However, not everyone knows that it also affects our cholesterol and may contribute to block the arteries.
Smoking rises the heart disease by changing the way our body manage cholesterol.
Tobacco tar, in fact, damages the immune cells. In smokers they are no longer able to capture bad cholesterol (LDL) and return it to the liver for elimination from the body.
The more LDL accumulates in the arteries the higher is the risk of stroke.
Also, when you smoke, sugars in tobacco burn creating acrolein your bloodstream absorbs through the lungs. Studies reveal that acrolein decreases the effectiveness of HDLs. Once again, the result is an increase in bad cholesterol values and, with it, the risk of heart disease.
How long after quitting smoking will my cholesterol improve?
Quitting smoking allows you to reduce your cholesterol in just 6 weeks but effects on your overall health begin much earlier.
In fact, 20 minutes after smoking a cigarette your heartbeat and blood pressure go back to normal values.
3 months after quitting smoke, respiratory functions and blood circulation improve significantly.
After a year without cigarettes, the risk of heart attack or heart complications decreases by half compared to a smoker.
Moderate alcohol consumption
Before to talk about the effects of alcohol on cholesterol, let’s do a distinction between moderate versus heavy alcohol intake.
According to the review published on National Library of Medicine by Gemma Chiva-Blanch and Lina Badimon, a low–moderate alcohol consumption may be linked to cardiovascular benefits. Also, alcohol in low quantity may improve the total cholesterol by slightly increasing the HDLs.
However, in the same review, authors point out that the alcohol cardiovascular benefits, when drunk in moderation, might have been overestimated. In fact, you can easily lower your cholesterol level by the same amount, simply exercising.
In the debate about the benefits of drinking alcohol in moderation there are many variables that come into play. For example: what is the safe consumption amount? Do age, gender and genetic make any difference?
Talking about heavy alcohol intake CDC and AHA have the same opinion. Heavy alcohol use increases triglycerides and total cholesterol levels, harms the liver and may lead to addiction.
If you want to lower cholesterol by cutting down on alcohol you should do the following:
- Limit the alcohol amount to 14 units a week.
Just to get an idea about alcohol units, in a pint of lower-strength beer there are 2 alcohol units. Instead, in a standard glass of red wine there are 2,1 alcohol units.
- Set drink-free days during the same week.
- Do not drink lots of alcohol in the same occasion (holidays, celebrations or anniversaries).
Statistics reveal that overweight or obese people, usually, also have high cholesterol and triglycerides as well as fatty liver disease. In fact, each 10 pounds of extra body fat means additional 10 mg of cholesterol produced every day.
This study says that “… patients who lost 5–10% of their weight showed significant reductions in triglycerides, total cholesterol, and low-density lipoprotein (LDL) cholesterol …”.
So, even a moderate and easy-to-achieve weight loss can help you to reduce cholesterol by decreasing LDL and increasing HDL.
Small changes in your daily habits can make a great difference. For example:
- Use the stairs instead of taking the elevator either at home and at work.
- Park your car farther than the office entrance so you’ll take more steps.
- Get up from your desk every hour and do some standing activity.
- Walk your dog more often or spend more time each walk.
- Avoid to snack in front the TV after dinner.
- Switch to healthy food and beverages for at least a short time and then repeat.
As seen in the article, cholesterol has several vital functions in the human body, but high levels of this fatty substance may cause build up on the arteries walls, narrow them and trigger different dangerous health diseases such as: hearth attack, clogged arteries, kidney failure and ictus (stroke).
If your lipid panel tells you your blood fat levels are too high, you should act immediately to lower cholesterol and triglycerides as quickly as possible.
The first thing healthcare providers suggest is to improve your diet. Avoid trans fats like margarine, biscuits, snacks and switch to unsaturated fats (avocados, almonds, olive oil, etc.). You may also try to add whey protein and sterols or stanols to your diet.
When the diet is not enough to reduce your cholesterol, you may integrate with dietary supplements like: niacin, red yeast rice, soluble fiber, L-carnitine and Omega-3.
To achieve the result, diet changes should go side by side a healthier lifestyle.
All cardiologists encourage their patients to exercise more, lose a few extra pounds, limit alcohol consumption and stop smoking.
When lifestyle and diet changes as well as physical exercise aren’t enough to lower cholesterol, medicines remain the last resort. Statins are the most common medication used in USA but alternatives are also available.
We highly recommend you to have blood test every 5 years in your 20s and every 3 years when older. In case the lipid panel says your fat levels are too high, talk immediately to your doctor before to take any action, supplements or medicine.